Estimation of IL-1β, Osteoprotegerin, and YKL-40: A Diagnostic Array for Prediction of Gestational Diabetes Mellitus complicated by Gestational Hypertension | ||
| The Egyptian Journal of Fertility and Sterility | ||
| Article 4, Volume 25, Issue 3, September 2021, Pages 31-43 PDF (3.29 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egyfs.2021.195175 | ||
| Author | ||
| Wagdy M Amer, Ali A Morsi, Hamasat A Alnoury1, 2, 3 | ||
| 1Department of Obstetrics & Gynecology (1) | ||
| 2Department of Clinical & , Chemical pathology (2) | ||
| 3Faculty of Medicine, Benha University(1,2), Egypt | ||
| Abstract | ||
| Objectives: Estimation of serum levels of interleukin (IL)- 1β, Osteoprotegerin (OPG) and YKL-40 early in pregnancy of normotensive normoglycemic women to find early predictors for development of gestational insulin resistance (GIR), hypertension (GHT) and/or diabetes mellitus (GDM). Patients & Methods: The study included 255 pregnant women who were evaluated during their 1st antenatal visit (ANV-1) for age, body mass index (BMI), baseline systolic (SBP) and diastolic blood pressure (DBP) and gave blood samples for estimation of serum levels of insulin and the studied cytokines. Then, all women underwent 75-Oral glucose tolerance test (OGTT) for diagnosis of GDM and the homeostasis model assessment of IR (HOMA-IR) score at 6th and 24th GW. Results: 32 women developed GIR that progressed to GDM, 38 women developed GHT, 13 developed GIR and GHT and 7 women developed the triad of GIR, GDM and GHT. There are significant differences in serum IL-1β, YKL-40 and OPG levels in women free and with these disorders. Serum levels of IL-1β showed positive, while serum OPG levels showed negative significant correlations with the incidence of pregnancy-induced disorders, while high serum YKL-40 was positively correlated with the incidence of GIR with GHT or GDM or both. ROC curve and Regression analyses defined combination of high DBP and serum YKL-40 as the significant early predictors for development of the three disorders, while high HOMA-IR score, SBP and serum IL-1β as the significant predictors for GHT, high BMI, DBP and serum YKL-40 as early predictors for GIR and GHT and high serum YKL-40 and low serum OPG levels as early predictors for GIR and DM. Conclusion: Estimation of the studied array of cytokines at the 1st ANV has a high diagnostic value for the upcoming pregnancy-induced disorders single or combination with higher predictive value than the reliance on clinical data. | ||
| Keywords | ||
| Keywords: Pregnancy; Insulin resistance; Diabetes mellitus; Hypertension; Cytokines; Early prediction | ||
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